101543 HOLLYWOOD'S BUMP & GRIND v ; 1irinnie1
INDIANA RETAIL TAX EXEMPT Page 1 of 1
Citof CERTIFICATE NO.003120155 002 0 PURCHASE ORDER NUMBER
FEDERAL EXCISE TAX EXEMPT 101543
ONE CIVIC SQUARE 35-6000972 THIS NUMBER MUST APPEAR ON INVOICES,NP
CARMEL, INDIANA 46032-2584 VOUCHER,DELIVERY MEMO,PACKING SLIPS,
SHIPPING LABELS AND ANY CORRESPONDENCE
FORM APPROVED BY STATE BOARD OF ACCOUNTS FOR CITY OF CARMEL-1997
PURCHASE ORDER DATE DATE REQUIRED REQUISITION NO. VENDOR NO. DESCRIPTION
3/29/2018 372102
HOLLYWOODS BUMP&GRIND Carmel Police Department
VENDOR ..10550 JESSUP BLVD SHIP :3 Civic Square;.
TO Carmel, IN .46032-
INDIANAPOLIS, IN 46280- Blaine Mallaber
PURCHASE ID - BLANKET CONTRACT PAYMENT TERMS
FREIGHT
24585
QUANTITY UNIT OF MEASURE DESCRIPTION UNIT PRICE EXTENSION
Department: 1110 Fund: 101 General Fund
Account: 43-510.00
1 Each . Auto Repairs $517.20 $517.20
Sub Total $517.20
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Send Invoice To:
Carmel Police Department Car 66-Morrow f
Accounts Payable "� 'S
3 Civic Square :X .
Carmel, IN.46032
PLEASE INVOICE IN DUPLICATE
DEPARTMENT ACCOUNT PROJECT I PROJECT ACCOUNT f AMOUNT
PAYMENT $517.20
SHIPPING INSTRUCTIONS *NP VOUCHER CANNOT BE APPROVED FOR PAYMENT UNLESS THE P.O. NUMBER IS MADE A
PART OF THE VOUCHER AND EVERY INVOICE AND VOUCHER HAS THE PROPER SWORN
*SHIP PREPAID. AFFIDAVIT ATTACHED. I HEREBY CERTIFY THAT THERE IS AN UNOBLIGATED BALANCE IN
•C.O.D.SHIPMENT CANNOT BE ACCEPTED. THIS APPROPRIATION SUFFICIENT TO PAY FOR THE ABOVE ORDER.
`PURCHASE ORDER NUMBER MUST APPEAR ON ALL SHIPPING LABEL
6
*THIS ORDER ISSUED IN COMPLIANCE WITH CHAPTER 99,ACTS 1945 i ` ,;)
AND ACTS AMENDATORY THEREOF AND SUPPLEMENT THERETO. ORDERED BY \\
Jim Barlow ,\,
TITLE Chief
CONTROL NO. 101543 CLERK-TREASURER